Depression in Diabetic Patients

Posted on June 19, 2014 at 1:07 pm

New research suggests that some people living with diabetes may be misdiagnosed as being depressed.[1] Rather, what they are experiencing is the reaction to living with a stressful, complex disease that is often hard to manage.1 However, a second study of patients with type I diabetes emphasizes the potential importance of treating depressive symptoms regardless of their cause.1 This study found that the greater depressive symptoms a patient reported, the higher that person’s mortality risk.1

“Because depression is measured with scales that are symptom-based and not tied to cause, in many cases these symptoms may actually reflect the distress that people are having about their diabetes, and not a clinical diagnosis of depression,” said lead author Lawrence Fisher, PhD, ABPP.1

Fisher and his team developed measures of diabetes-specific distress that reflect whether a person had been feeling worried about a variety of problems associated with living with their diabetes, such as hypoglycemia.1 They also asked patients to fill out the Patient Health Questionnaire (PHQ8) to measure depressive symptoms.1

Those who reported high levels of distress and high levels of depressive symptoms were assigned one of three interventions—all of which were designed to reduce the distress associated with managing diabetes, rather than symptoms of depression.1 One group took part in an online diabetes self-management program.1 A second participated in an online program and received individual assistance to problem solve issues related to their diabetes distress.1 A third was provided with personalized health risk information and send educational materials regarding diabetes through the mail.1 All three groups received personal phone calls throughout the project, as well.1

All three interventions significantly reduced distress and depressive symptoms over a 12-month period, and patient maintained those reductions over the course of the study.1

“Overall, 84 percent of those scoring above 10 on the PHQ8 (maximum 27, with 10 being moderate depression) reduced their levels of depression to below 10 following the interventions,” said Fisher. “What’s important about this is that many of the depressive symptoms reported by people with type II diabetes are really related to their diabetes, and don’t have to be considered psychopathology. So they can be addressed as part of the spectrum of the experience of diabetes and dealt with by their diabetes care team.”1